Thrombolytic therapy for acute stroke in Mexico: Experience of four Mexican hospitals

Antonio Arauz-Góngora, Beatriz Mendez, Eduardo Soriano-Navarro, Angélica Ruiz-Franco, Jimena Quinzaños, Marlene Rodríguez-Barragán, Erick García-Valadez, Fernando Góngora-Rivera
2019 Revista Mexicana de Neurociencia  
Although the efficacy of intravenous thrombolysis (IV-T) has been widely demonstrated, the rates of its use continue to be low. Purpose: The purpose of this study was to assess the frequency of IV-T in Mexican hospitals and to describe the target times for acute treatment and the functional evolution of patients. Methods: Data prospectively collected from patients with acute ischemic stroke treated over a period of 2 years in four Mexican hospitals were analyzed. We assessed demographic data,
more » ... e onset-to-door (OTD) time, the door-to-needle (DTN) time, treatment and the National Institutes of Health Stroke Scale (NIHSS), and modified Rankin scale (mRs) scores at the baseline and at the end of the follow-up. Results: There were 500 patients (mean age 57 ± 14 years, 274 [55%] men). The median OTD time was 11 h (range 30 min-190 h); the mean of NIHSS score was 10 ± 6. Eighty-seven (17.4%) patients arrived at the hospital within 4.5 h; but only 38 (7.6%) patients were treated with IV-T (mean of NIHSS 12 ± 6 points; with a mean OTD time of 2.1 h and a DTN time of 82 ± 51 min). After a median follow-up of 6 months (range 5-24 months), the final NIHSS score was 7 ± 6 points. A better prognosis was observed (mRs < 2) in patients who received IV-T (p = 0.04). Conclusions: The frequency of IV-T in Mexican hospitals continues to be <10%. A high percentage of patients continues to arrive at the hospital outside the therapeutic window. Terapia trombolítica para el infarto cerebral agudo en México: experiencia de cuatro hospitales Mexicanos Resumen Antecedentes y objetivo: Aunque la eficacia de la trombólisis intravenosa (T-IV) está ampliamente probada, las tasas de uso continúan siendo bajas. Nuestro objetivo fue valorar la frecuencia de T-IV en hospitales mexicanos, describir los tiempos meta de tratamiento agudo y la evolución funcional de los pacientes. Pacientes y métodos: Los datos demográficos, tiempos de llegada al hospital; puerta aguja (TP-A) y el tratamiento empleado de pacientes con infarto cerebral agudo (ICA) y
doi:10.24875/rmn.19000112 fatcat:wzj63l4cdbf47dy5hblfv6l2iy